Document Decision-Making and Follow-up: Provide written evidence of clinical/ethical decision-making and results of implementation
Write as "actual" notes ...
See Wheeler book, pp. 115 and following
Also, Corey (documenting every piece of interaction) ...
Pope, K., & Vasquez, M. (2005). Creating strategies for self-care. How to survive and thrive as a therapist: Information, ideas, and resources for psychologists in practice (pp. 13-21). American Psychological Association. doi:10.1037/11088-003.
Writing evidence and keeping record of conversations is part of self care for the practitioner as well as a benefit to avoiding malpractice and client harm.
These notes are best made in the psychotherapy notes section of documentation. Carol will be "analyzing the content of conversation during a private counseling session that are separated from the re of the individual's record"(Bertram &Wheeler, 2008).
Marianne Corey talks about her experiences as a therapist working in a small town. She writes, "Being a practitioner in a small town community demands flexibility, honesty, and sensitivity"(Corey, Corey, & Callanan, 2007).
The following is a draft of the psychotherapy notes Carol:
Write as "actual" notes ...
See Wheeler book, pp. 115 and following
Also, Corey (documenting every piece of interaction) ...
Pope, K., & Vasquez, M. (2005). Creating strategies for self-care. How to survive and thrive as a therapist: Information, ideas, and resources for psychologists in practice (pp. 13-21). American Psychological Association. doi:10.1037/11088-003.
Writing evidence and keeping record of conversations is part of self care for the practitioner as well as a benefit to avoiding malpractice and client harm.
These notes are best made in the psychotherapy notes section of documentation. Carol will be "analyzing the content of conversation during a private counseling session that are separated from the re of the individual's record"(Bertram &Wheeler, 2008).
Marianne Corey talks about her experiences as a therapist working in a small town. She writes, "Being a practitioner in a small town community demands flexibility, honesty, and sensitivity"(Corey, Corey, & Callanan, 2007).
The following is a draft of the psychotherapy notes Carol: